ASK THE PHARMACIST | How safe are multivitamins we can buy without a prescription?

Even though a varied diet is the preferred and safest way to achieve good nutrition and a healthy body, we sometimes need to compensate for an inadequate diet or boost our wellbeing with health supplements. 

A wide range of supplements is available without a prescription from pharmacies, supermarkets, health shops and online. Ingredients in health supplements are not limited to vitamins and minerals, but also include fish oils, protein, collagen and more.  

The South African Health Products Regulatory Authority (Sahpra) is responsible for the quality, efficacy and safety of all medicines in the country, including health supplements. 

Suppliers of health supplements need a licence from Sahpra to sell their products. This, among other checks, ensures the correct principles and procedures are followed so these medicines are produced consistently, are harmless, and work as they should.

Sahpra also requires specific information is mentioned on the product label and a patient leaflet is included with the product. Among other requirements, the label should list the ingredients and their concentrations. 

Specific levels of ingredients are allowed in health supplements for use in adults and children. If more than a certain amount is included in a product, it may have a higher schedule and not be classified as a health supplement. You may need to have a prescription to buy it. If the product contains too little of a specific ingredient, the supplier is not allowed to make certain claims.

Let me give an example: the maximum level of vitamin C in health supplements for adults is 1,000mg and the minimum is 6mg per day. Taking too little of a vitamin or mineral might be harmless, but will also waste your money. It will be cheaper and more satisfying to eat an orange. 

Some health supplements are not meant for children owing to their ingredients. 

Making a claim

On the product label, the manufacturer is allowed to make certain claims and state the indications (the health condition or symptom the supplement targets or supports). vitamin C can, for example, support good health, function as an antioxidant and contribute to the reduction of tiredness.

Claims that include words like “magical”, “no side effects”, “world’s best” or “guaranteed”, or refer to the diagnosis, treatment or cure of any disease are not acceptable for health supplements. In other words, be wary if a product label says the product is “the world’s No 1 product for cancer”. 

Products with scheduled ingredients or injectable forms of medicine are not considered health supplements. Even though this might sound confusing, the following disclaimer on the product label is an indication the product is adhering to the Sahpra guidelines for health supplements: “This unregistered medicine has not been evaluated by the Sahpra for its quality, safety or intended use.”

It is unfortunately possible for products of a low quality or from unlicensed suppliers to make their way to store shelves. 

My advice is to buy well-known brands from a retailer with a good reputation or your local pharmacy. 

* Thealdi Mitchell is a qualified registered pharmacist (B.Pharm) and managing editor of MIMS, a leading South African medical reference publisher owned by Arena Holdings (Pty) Ltd. She has experience in retail and hospital pharmacy, manufacturing and the medical aid industry. She believes in a holistic approach to health and taking small, daily steps to make better choices in self-care.

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